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Lindner O, Schäfer W, Rischpler C, Silber S, Burchert W. Myocardial perfusion SPECT in Germany from 2012 to 2021: insights into development and quality indicators. Eur J Nucl Med Mol Imaging 2023; 50:1621-1628. [PMID: 36780003 PMCID: PMC9923638 DOI: 10.1007/s00259-023-06129-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/26/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE This paper summarises the results of 4 national surveys on the numbers, utilisation and technique of myocardial perfusion SPECT (MPS) from 2012 to 2021. METHODS A one-page questionnaire for information on MPS in 2012, 2015, 2018 and 2021 was sent to German centres practising nuclear medicine. To check for representativeness, the numbers obtained were related to official annual data and furthermore to the numbers of invasive coronary angiography procedures (ICA). RESULTS MPS examinations increased by > 40% from 2012 to 2021 and showed a centralisation with increasing MPS per centre. In 2020, a mild impact of the COVID-19 pandemic could be observed in the form of only a slight MPS increase, which was compensated in the following year. Outpatient care cardiologists represent the most important referrer (70%). Mostly, 2-day protocols were used. One-day protocols and stress-only protocols showed insignificant changes. The use of exercise stress decreased steadily. In 2021, exercise stress was replaced by pharmacological stress as the most frequent stress modality. Camera systems showed a shift to more SPECT-CT systems. The use of gated SPECT increased to almost 90%. Quantitative scoring showed an increasing acceptance. The ratio of invasive coronary angiographies (ICA) to MPS was between 3.9 and 4.5. A significant proportion of ICA in the context of CCS (chronic coronary syndrome) was performed without prior testing for ischaemia. CONCLUSION The 2012 to 2021 MPS surveys reveal a continuously growing number of examinations with only a mild temporary effect of the COVID-19 pandemic and a centralisation with increasing numbers per centre. Performance and technical data reveal a high-grade adherence of MPS practice to the current ESC guideline. A large potential of non-invasive diagnostics remains for the future.
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Affiliation(s)
- O Lindner
- Institut Für Radiologie, Nuklearmedizin Und Molekulare Bildgebung, Herz- Und Diabeteszentrum NRW, Bad Oeynhausen, Germany.
| | - W Schäfer
- Klinik Für Nuklearmedizin, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany
| | - C Rischpler
- Klinik Für Nuklearmedizin, Universitätsklinik Essen, Stuttgart, Germany
- Abteilung für Nuklearmedizin, Klinikum Stuttgart, Stuttgart, Germany
| | - S Silber
- Kardiologie Zentrum München, Munich, Germany
| | - W Burchert
- Institut Für Radiologie, Nuklearmedizin Und Molekulare Bildgebung, Herz- Und Diabeteszentrum NRW, Bad Oeynhausen, Germany
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Ernst T, Szidat S, Handl J, Jakob D, Michel R, Schnabel C, Synal HA, Santos Arevalo FJ, Benne I, Boess J, Gehrt E, Capelle A, Schneider J, Schäfer W, Böttcher J. Migration of iodine-129 and iodine-127 in soils. KERNTECHNIK 2022. [DOI: 10.1515/kern-2003-0070] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
To draw the balance of anthropogenic 129I input into European soils, the concentrations of 129I and 127I in seven soils from Lower Saxony were analyzed down to a depth of 250 cm. In comparison with pre-nuclear soils and Ukrainian soils, we detected a significant anthropogenic input of 129I. Considering the different time periods for the input of 129I and 127I it was possible to assess the dynamics of sorption processes which dominate migration and accumulation. Anthropogenic 129I was successfully used as a tracer for a clarification of the migration processes of trace elements in soils.
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Affiliation(s)
- T. Ernst
- Center for Radiation Protection and Radioecology, University Hanover , Am Kleinen Felde 30 , Hannover , Germany
| | - S. Szidat
- Center for Radiation Protection and Radioecology, University Hanover , Am Kleinen Felde 30 , Hannover , Germany
| | - J. Handl
- Center for Radiation Protection and Radioecology, University Hanover , Am Kleinen Felde 30 , Hannover , Germany
| | - D. Jakob
- Center for Radiation Protection and Radioecology, University Hanover , Am Kleinen Felde 30 , Hannover , Germany
| | - R. Michel
- Center for Radiation Protection and Radioecology, University Hanover , Am Kleinen Felde 30 , Hannover , Germany
| | - Ch. Schnabel
- Laboratory for Radiochemistry and Environmental Chemistry, University Bern , Freiestrasse 3 , Bern , Switzerland
- Institute for Particle Physics, ETH Hoenggerberg , Zurich , Switzerland
| | - H.-A. Synal
- Paul Scherrer Institute, c/o Institute for Particle Physics , ETH Hoenggerberg , Zurich , Switzerland
| | | | - I. Benne
- State Geological Survey of Lower Saxony (NLfB) , Stilleweg 2 , Hannover , Germany
| | - J. Boess
- State Geological Survey of Lower Saxony (NLfB) , Stilleweg 2 , Hannover , Germany
| | - E. Gehrt
- State Geological Survey of Lower Saxony (NLfB) , Stilleweg 2 , Hannover , Germany
| | - A. Capelle
- State Geological Survey of Lower Saxony (NLfB) , Stilleweg 2 , Hannover , Germany
| | - J. Schneider
- State Geological Survey of Lower Saxony (NLfB) , Stilleweg 2 , Hannover , Germany
| | - W. Schäfer
- NLfB Soil-Technological Institute , Friedrich-Mißler-Straße 46/48 , Bremen , Germany
| | - J. Böttcher
- Institute of Soil Science, University Hanover , Herrenhäuser Straße 2 , Hannover , Germany
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3
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Dähnert L, Schlosser J, Fast C, Fröhlich A, Gröner A, Lange E, Roth NJ, Schäfer W, Schröder C, Eiden M, Groschup MH. Hepatitis E virus: Efficacy of pasteurization of plasma-derived VWF/FVIII concentrate determined by pig bioassay. Transfusion 2021; 61:1266-1277. [PMID: 33605455 DOI: 10.1111/trf.16298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hepatitis E virus (HEV) is the leading cause of acute hepatitis throughout the world. Increasing blood component transfusion-associated HEV infections highlight the need for reliable virus inactivation procedures for plasma derivatives from pooled plasma donations. STUDY DESIGN AND METHODS An animal infection study was conducted to evaluate the efficiency of HEV inactivation by pasteurization during the manufacturing process of the von Willebrand Factor/Factor VIII (VWF/FVIII) concentrate Haemate P/Humate-P (CSL Behring, Marburg, Germany). For this purpose, groups of pigs were inoculated with stabilized VWF/FVIII intermediate spiked with HEV-positive liver homogenate and exposed to increasing incubation times of 0, 3, 6, and 10 h at 60°C. Animals were evaluated for virus replication over 27 days and in a subsequent trial over 92 days. RESULTS Virus replication was detected in animals up to the 6-h pasteurization group. In contrast, pasteurization for 10 h did not reveal virus detection when the observation period was 27 days. In an additional experiment using the 10-h pasteurized material, two individuals started virus excretion and seroconverted when the observation period was extended to 92 days. Based on the total infection rate (2 of 12) of the animals inoculated with the sample pasteurized for 10 h, a virus reduction factor of at least 4.7 log10 is calculated. CONCLUSION This study demonstrates that pasteurization at 60°C for 10 h of an HEV-positive plasma derivative leads to the effective reduction of infectivity, resulting in a VWF/FVIII product with an appropriate margin of safety for HEV.
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Affiliation(s)
- Lisa Dähnert
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald, Germany
| | - Josephine Schlosser
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald, Germany.,Department of Veterinary Medicine, Freie Universität Berlin, Institute of Immunology, Berlin, Germany
| | - Christine Fast
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald, Germany
| | - Andreas Fröhlich
- Institute of Epidemiology, Friedrich-Loeffler-Institut, Greifswald, Germany
| | | | - Elke Lange
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institut, Greifswald, Germany
| | - Nathan J Roth
- Global Pathogen Safety, CSL Behring AG, Bern, Switzerland
| | | | - Charlotte Schröder
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institut, Greifswald, Germany
| | - Martin Eiden
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald, Germany
| | - Martin H Groschup
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Greifswald, Germany
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Schräder T, Koch J, Ross R, Schäfer W, Keiner B, Roth NJ, Widmer E. Effective coronavirus reduction by various production steps during the manufacture of plasma-derived medicinal products. Transfusion 2020; 60:1334-1335. [PMID: 32542716 PMCID: PMC7323209 DOI: 10.1111/trf.15850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Tobias Schräder
- Global Pathogen Safety (GPS), CSL Behring, USA.,CSL Behring GmbH, Marburg, Germany
| | - Julia Koch
- Global Pathogen Safety (GPS), CSL Behring, USA.,CSL Behring GmbH, Marburg, Germany
| | - Rachael Ross
- Global Pathogen Safety (GPS), CSL Behring, USA.,CSL Behring (Australia) Pty Ltd, Broadmeadows, Victoria, Australia
| | - Wolfram Schäfer
- Global Pathogen Safety (GPS), CSL Behring, USA.,CSL Behring GmbH, Marburg, Germany
| | - Björn Keiner
- Global Pathogen Safety (GPS), CSL Behring, USA.,CSL Behring GmbH, Marburg, Germany
| | - Nathan J Roth
- Global Pathogen Safety (GPS), CSL Behring, USA.,CSL Behring AG, Bern, Switzerland
| | - Eleonora Widmer
- Global Pathogen Safety (GPS), CSL Behring, USA.,CSL Behring AG, Bern, Switzerland
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5
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Gerlach M, Wolff S, Ludwig S, Schäfer W, Keiner B, Roth NJ, Widmer E. Rapid SARS-CoV-2 inactivation by commonly available chemicals on inanimate surfaces. J Hosp Infect 2020; 106:633-634. [PMID: 32916211 PMCID: PMC7480442 DOI: 10.1016/j.jhin.2020.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/01/2020] [Indexed: 12/23/2022]
Affiliation(s)
- M Gerlach
- CSL Behring GmbH, Global Pathogen Safety, Marburg, Germany.
| | - S Wolff
- CSL Behring GmbH, Global Pathogen Safety, Marburg, Germany
| | - S Ludwig
- Westfaelische Wilhelms-University Muenster, Institute of Virology, Muenster, Germany
| | - W Schäfer
- CSL Behring GmbH, Global Pathogen Safety, Marburg, Germany
| | - B Keiner
- CSL Behring GmbH, Global Pathogen Safety, Marburg, Germany
| | - N J Roth
- CSL Behring GmbH, Global Pathogen Safety, Marburg, Germany
| | - E Widmer
- CSL Behring GmbH, Global Pathogen Safety, Marburg, Germany
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6
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Bolognino A, Szczurek A, Schäfer W. Exclusive production of
ϕ
meson in the
γ*p→ϕp
reaction at large photon virtualities within
kT
-factorization approach. Int J Clin Exp Med 2020. [DOI: 10.1103/physrevd.101.054041] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Höfner K, Hampel C, Kirschner-Hermanns R, Alloussi SH, Bauer RM, Bross S, Bschleipfer T, Goepel M, Haferkamp A, Hüsch T, Kaufmann A, Kiss G, Kranz J, Oelke M, Pannek J, Reitz A, Rutkowski M, Schäfer W, Schulte-Baukloh H, Schumacher S, Seif C, Schultz-Lampel D. [Use of synthetic slings and mesh implants in the treatment of female stress urinary incontinence and prolapse : Statement of the Working Group on Urological Functional Diagnostics and Female Urology of the Academy of the German Society of Urology]. Urologe A 2020; 59:65-71. [PMID: 31741004 DOI: 10.1007/s00120-019-01074-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Due to a safety alert issued by the US Food and Drug Administration (FDA) in 2011 for transvaginal mesh implants to treat female prolapse as a result of numerous reports of complications such as infection, chronic pain, dyspareunia, vaginal erosion, shrinkage and erosion into other organs nearly all industrial products have been withdrawn from the market in the meantime. The United Kingdom, Australia, and New Zealand extended warnings and prohibitions even on the implantation of midurethral slings (TVT, TOT). In view of these current international controversies regarding the use of implanted materials for the treatment of stress incontinence and prolapse and the lack of clear guidelines for the use of biomaterials, the opinion of the Working Group on Urological Functional Diagnostics and Female Urology should provide clarity. The Opinion is based on the SCENIHR Report of the "European Commission's Scientific Committee on Emerging and Newly Identified Health Risks", the "Consensus Statement of the European Urology Association and the European Urogynaecological Association on the Use of Implanted Materials for Treating Pelvic Organ Prolapse and Stress Urinary Incontinence" and in compliance with relevant EAU and national guidelines and the opinion of the Association for Urogynaecology and Plastic Pelvic Floor Reconstruction (AGUB eV). In addition, recommendations are given for the future handling of implants of slings and meshes for the treatment of stress incontinence and prolapse from a urologic viewpoint.
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Affiliation(s)
- K Höfner
- Urologische Klinik, Evangelisches Krankenhaus Oberhausen, Virchowstr. 20, 46047, Oberhausen, Deutschland.
| | - C Hampel
- Urologische Abteilung, Marien-Hospital Erwitte, Erwitte, Deutschland
| | - R Kirschner-Hermanns
- Neuro-Urologie/Urologie Universitätsklinikum Bonn und Neuro-Urologie, Neurologisches Rehabilitationszentrum der Godeshöhe e. V., Bonn, Deutschland
| | - S H Alloussi
- Abteilung Urologie, Universitätsspital Basel, Basel, Schweiz
| | - R M Bauer
- Urologische Klinik und Poliklinik der Ludwig-Maximilians-Universität München, Campus Großhadern, München, Deutschland
| | - S Bross
- Urologische Klinik, Fürst-Stirum-Klinik Bruchsal, Bruchsal, Deutschland
| | - T Bschleipfer
- Klinik für Urologie, Andrologie und Kinderurologie, Klinikum Weiden/Kliniken Nordoberpfalz AG, Weiden i. d. Oberpfalz, Deutschland
| | - M Goepel
- Klinik für Urologie und Nephrologie, Helios Klinikum Niederberg, Velbert, Deutschland
| | - A Haferkamp
- Urologische Klinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - T Hüsch
- Urologische Klinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - A Kaufmann
- Zentrum für Kontinenz und Neuro-Urologie, Kliniken Maria Hilf GmbH Mönchengladbach, Mönchengladbach, Deutschland
| | - G Kiss
- Institution Neuro-Urologische Ambulanz, Univ. Klinik f. Urologie Innsbruck, Innsbruck, Österreich
| | - J Kranz
- St.-Antonius Hospital, Klinik für Urologie und Kinderurologie Eschweiler, Eschweiler, Deutschland
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - M Oelke
- Klinik für Urologie, Kinderurologie und Urologische Onkologie, St. Antonius-Hospital Gronau, Gronau, Deutschland
| | - J Pannek
- Neuro-Urologie, Schweizer Paraplegiker-Zentrum Nottwil, Nottwil, Schweiz
- Urologische Klinik, Inselspital, Universitätsspital, Universität Bern, Bern, Schweiz
| | - A Reitz
- KontinenzZentrum Hirslanden Zürich, Zürich, Schweiz
| | - M Rutkowski
- Urologische Klinik, Landesklinikum Korneuburg, Korneuburg, Österreich
| | | | - H Schulte-Baukloh
- Urologie Turmstraße (Gemeinschaftspraxis), Berlin Mitte/Moabit, Deutschland
| | - S Schumacher
- Urology Department, Healthpoint Hospital, Abu Dhabi, Vereinigte Arabische Emirate
| | - C Seif
- Urologiezentrum Alter Markt, Kiel, Deutschland
| | - D Schultz-Lampel
- Kontinenzzentrum Südwest, Schwarzwald-Baar Klinikum Villingen-Schwenningen, Villingen-Schwenningen, Deutschland
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8
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Babiarz I, Schäfer W, Szczurek A. Production of χc meson pairs with additional emission. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201919904011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We discus mechanism of double χc production with large rapidity separation. The first order pertubative correction to gg→χcχc process includes additional emission of gluon among χc pair. We have considered real gluon distribution as well as virtual correction to the production process of χc pairs. Results for two scalar χc0χc0 and two axial mesons χc1χc1 are shown.
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9
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Dähnert L, Eiden M, Schlosser J, Fast C, Schröder C, Lange E, Gröner A, Schäfer W, Groschup MH. High sensitivity of domestic pigs to intravenous infection with HEV. BMC Vet Res 2018; 14:381. [PMID: 30514313 PMCID: PMC6278151 DOI: 10.1186/s12917-018-1713-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 11/23/2018] [Indexed: 12/17/2022] Open
Abstract
Background Hepatitis E virus (HEV) is one major cause of acute clinical hepatitis among humans throughout the world. In industrialized countries an increasing number of autochthonous HEV infections have been identified over the last years triggered by food borne as well as – to a much lower degree – by human to human transmission via blood transfusion. Pigs have been recognised as main reservoir for HEV genotype 3 (HEV-3), and zoonotic transmission to humans through undercooked/raw meat is reported repeatedly. The minimal infectious dose of HEV-3 for pigs is so far unknown. Results The minimum infectious dose of HEV-3 in a pig infection model was determined by intravenous inoculation of pigs with a dilution series of a liver homogenate of a HEV infected wild boar. Seroconversion, virus replication and shedding were determined by analysis of blood and faeces samples, collected over a maximum period of 91 days. A dose dependent incubation period was observed in faecal shedding of viruses employing a specific and sensitive PCR method. Faecal viral shedding and seroconversion was detected in animals inoculated with dilutions of up to 10− 7. This correlates with an intravenously (i.v.) administered infectious dose of only 6.5 copies in 2 ml (corresponding to 24 IU HEV RNA/ml). Furthermore the first detectable shedding of HEV RNA in faeces is clearly dose dependent. Unexpectedly one group infected with a 10− 4 dilution exhibited prolonged virus shedding for more than 60 days suggesting a persistent infection. Conclusion The results indicate that pigs are highly susceptible to i.v. infection with HEV and that the swine model represents the most sensitive infectivity assay for HEV so far. Considering a minimum infectious dose of 24 IU RNA/ml our findings highlights the potential risk of HEV transmission via blood and blood products. Electronic supplementary material The online version of this article (10.1186/s12917-018-1713-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lisa Dähnert
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald, Insel Riems, Germany
| | - Martin Eiden
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald, Insel Riems, Germany
| | - Josephine Schlosser
- Department of Veterinary Medicine, Institute of Immunology, Freie Universität Berlin, Robert-von-Ostertag-Straße 7-13, 14163, Berlin, Germany
| | - Christine Fast
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald, Insel Riems, Germany
| | - Charlotte Schröder
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institut, 17493, Greifswald, Insel Riems, Germany
| | - Elke Lange
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institut, 17493, Greifswald, Insel Riems, Germany
| | - Albrecht Gröner
- PathoGuard Consult, Fasanenweg 6, 64342, Seeheim-Jugenheim, Germany
| | - Wolfram Schäfer
- CSL Behring Biotherapies for Life™, P.O. Box 1230, 35002, Marburg, Germany
| | - Martin H Groschup
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald, Insel Riems, Germany.
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10
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Bochud M, Schäfer W, Roth NJ, Ros C. Characterization of a quasi-enveloped, fast replicating hepevirus from fish and its use as hepatitis E virus surrogate. J Virol Methods 2018; 263:111-119. [PMID: 30399394 DOI: 10.1016/j.jviromet.2018.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/23/2018] [Accepted: 11/02/2018] [Indexed: 02/06/2023]
Abstract
Hepatitis E virus (HEV) is an emerging concern for the safety of plasma-derived medicinal products. The lack of an efficient cell culture system hampers the studies on HEV biology as well as validation studies to test the capacity of virus reduction steps to clear HEV. Hence, a surrogate hepevirus that can efficiently replicate in cell culture is needed. Cutthroat trout virus (CTV) is a non-pathogenic fish hepevirus, which can replicate in cell culture to high titers. Under interferon inhibition, CTV replication reached up to 5 × 107 genome equivalents per μL in 4-5 days. The intracellular CTV progeny was already lipid-associated, suggesting that the envelope is acquired from intracellular membranes. Transmission electron microscopy of purified quasi-enveloped virus revealed exosome-like structures with an average size of 40 nm, in contrast to 27-34 nm for the non-enveloped virus. The quasi-enveloped virus was significantly less infectious than the non-enveloped virus. Assays based on quantitative RT-PCR, immunofluorescence and immunocytochemistry were established to evaluate virus inactivation. Cold ethanol fractionation removed 3.0 log of CTV and pasteurization of human albumin inactivated more than 3.7 log to below the limit of detection. Similar to HEV, virus replication was promoted in the presence of 17β-estradiol, an effect that can contribute to the understanding of the exacerbated virulence of HEV in pregnant women. These results together reveal substantial similarities between the human and fish HEV and validate CTV as a practical virus model to use in some applications for evaluating the HEV reduction capacity of biological manufacturing process steps.
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Affiliation(s)
- Maëlle Bochud
- Department of Chemistry and Biochemistry, University of Bern, Freiestrasse 3, 3012 Bern, Switzerland
| | - Wolfram Schäfer
- CSL Behring GmbH, Emil-von-Behring-Strasse 76, 35041, Marburg, Germany
| | - Nathan J Roth
- CSL Behring AG, Wankdorfstrasse 10, 3000, Bern 22, Switzerland
| | - Carlos Ros
- Department of Chemistry and Biochemistry, University of Bern, Freiestrasse 3, 3012 Bern, Switzerland.
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11
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Kroezen M, Schäfer W, Sermeus W, Hansen J, Batenburg R. Healthcare assistants in EU Member States: an overview. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Kroezen
- Erasmus University Medical Centre, Rotterdam, Netherlands
| | - W Schäfer
- Feinberg School of Medicine, Department of Social Medical Sciences, Northwestern University, Chicago, USA
| | - W Sermeus
- KU Leuven Institute for Healthcare Policy (LIGB), University of Leuven, Leuven, Belgium
| | - J Hansen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
| | - R Batenburg
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
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12
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Roth K, Zahradnik HP, Schäfer W. Effects of different progestins on prostaglandin biosynthesis in human endometrial explants. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- K Roth
- University Medical Center Freiburg, Department of Obstetrics and Gynecology, Freiburg, Deutschland
| | - HP Zahradnik
- University Medical Center Freiburg, Department of Obstetrics and Gynecology, Freiburg, Deutschland
| | - W Schäfer
- University Medical Center Freiburg, Department of Obstetrics and Gynecology, Freiburg, Deutschland
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13
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Schäfer W, Meyer A, Knollmann D. Beim Emphysempatienten korrelieren – im Gegensatz zum „Lungengesunden“ – relatives Lungenlappenvolumen und relative Lungenlappenperfusion nur sehr schwer. Pneumologie 2018. [DOI: 10.1055/s-0037-1619354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- W Schäfer
- Nuklearmedizin, Kliniken Maria Hilf, Mönchengladbach
| | - A Meyer
- Kliniken Maria Hilf, Mönchengladbach
| | - D Knollmann
- Nuklearmedizin, Kliniken Maria Hilf, Mönchengladbach
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Bonciani M, Schäfer W, Barsanti S, Heinemann S, Groenewegen PP. The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries. BMC Health Serv Res 2018; 18:132. [PMID: 29466980 PMCID: PMC5822600 DOI: 10.1186/s12913-018-2913-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 02/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background There is no clear evidence as to whether the co-location of primary care professionals in the same facility positively influences their way of working and the quality of healthcare as perceived by patients. The aim of this study was to identify the relationships between general practitioner (GP) co-location with other GPs and/or other professionals and the GP outcomes and patients’ experiences. Methods We wanted to test whether GP co-location is related to a broader range of services provided, the use of clinical governance tools and inter-professional collaboration, and whether the patients of co-located GPs perceive a better quality of care in terms of accessibility, comprehensiveness and continuity of care with their GPs. The source of data was the QUALICOPC study (Quality and Costs of Primary Care in Europe), which involved surveys of GPs and their patients in 34 countries, mostly in Europe. In order to study the relationships between GP co-location and both GPs’ outcomes and patients’ experience, multilevel linear regression analysis was carried out. Results The GP questionnaire was filled in by 7183 GPs and the patient experience questionnaire by 61,931 patients. Being co-located with at least one other professional is the most common situation of the GPs involved in the study. Compared with single-handed GP practices, GP co-location are positively associated with the GP outcomes. Considering the patients’ perspective, comprehensiveness of care has the strongest negative relationship of GP co-location of all the dimensions of patient experiences analysed. Conclusions The paper highlights that GP mono- and multi-disciplinary co-location is related to positive outcomes at a GP level, such as a broader provision of technical procedures, increased collaboration among different providers and wider coordination with secondary care. However, GP co-location, particularly in a multidisciplinary setting, is related to less positive patient experiences, especially in countries with health systems characterised by a weak primary care structure.
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Affiliation(s)
- M Bonciani
- Laboratorio Management e Sanità, Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - W Schäfer
- Netherlands Institute for Health Services Research-NIVEL, Utrecht, The Netherlands
| | - S Barsanti
- Laboratorio Management e Sanità, Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S Heinemann
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.,Department of Nursing and Health Sciences, University of Applied Sciences Fulda, Fulda, Germany
| | - P P Groenewegen
- Netherlands Institute for Health Services Research-NIVEL, Utrecht, The Netherlands.,Department of Sociology, Department of Human Geography, Utrecht University, Utrecht, The Netherlands
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Bengel F, Büll U, Burchert W, Kies P, Kluge R, Krause BJ, Lindner O, Nienaber C, Nowak B, Schäfer W, Schober O, Schwaiger M, Silber S, Stegger L, vom Dahl J, Zimmermann R, Schäfers M. Position paper nuclear cardiology: Update 2008. Nuklearmedizin 2018. [DOI: 10.3413/nukmed-0220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
SummaryNuclear cardiology is well established in clinical diagnostic algorithms for many years. This is an update 2008 of the first common position paper of the German Association of Nuclear Medicine and the German Association of Cardiology, Heart and Circulation Research published in 2001 aiming at an overview of state-of-the-art scintigraphic methods.
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Schirp U, Zimny M, Sabri O, Nowak B, Schäfer W, Cremerius U, Büll U, Reinartz P. Optimizing ventilation-perfusion lung scintigraphy: Parting with planar imaging. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1623990] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim of the study was to introduce and verify a ventilation-perfusion (V/Q) acquisition protocol that incorporates new developments in scintigraphy in order to allow for a more balanced comparison with other diagnostic procedures. Methods: In 103 patients suspect of having pulmonary embolism, V/Q scans were acquired exclusively with SPECT technique. Ventilation was done with ultrafine aerosol. Planar images in eight directions were reconstructed through addition of three consecutive SPECT projections. Three referees examined the scans in regard to type, localization, and extent of V/Q defects. Results: Using this protocol, significantly more defects, especially of subsegmental size, were detected (p <0.Q1). Sensitivity, and diagnostic accuracy were also significantly improved (p <0.01) to 0.96, and 0.99, respectively. Furthermore, kappa values were increased up to 0.82 - a relevant enhancement in the ability to precisely localize V/Q defects. Conclusion: In conclusion this protocol provides high-resolution tomographic scans as well as high-quality planar images within a short acquisition time. Due to the significant increase in lesion detection, sensitivity, diagnostic accuracy, and anatomical localization of defects, it is a substantial improvement in the diagnosis of pulmonary embolism that will put V/Q scintigraphy on a par with other tomographic methods.
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Burchert W, Bengel FM, Zimmermann R, vom Dahl J, Schäfer W, Büll U, Schober O, Schwaiger M, Kluge R, Schäfers M, Lindner O. Myocardial perfusion scintigraphy in Germany. Nuklearmedizin 2018. [DOI: 10.1055/s-0037-1621023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN), in cooperation with the working group Nuclear Cardiology of the German Cardiac Society (DGK), decided to conduct a national survey on myocardial perfusion scintigraphy (MPS). Method: A questionnaire to evaluate MPS for the year 2005 was sent. Results: 346 completed questionnaires had been returned (213 private practices, 99 hospitals and 33 university hospitals). MPS of 112 707 patients were reported with 110 747 stress and 95 878 rest studies. The majority (>75%) was performed with 99mTc-MIBI or tetrofosmin. 201Tl stress-redistribution was used in 22 637 patients (20%). The types of stress were exercise in 78%, vasodilation with adenosine or dipyridamol in 21% and dobutamine in 1%. 99.97% of all MPS were SPECT studies. Gated SPECT was performed in 36% of the stress and in 32% of the rest studies. An attenuation correction was used in 21%. 29 institutions (8%) performed gated SPECT (stress and rest) and attenuation correction. 47% of all MPS were requested by ambulatory care cardiologists, 17% by internists, 12% by primary care physicians, 21% by hospital departments and 2% by others. Conclusion: In Germany, MPS is predominantly performed with 99mTc-perfusion agents. The common type of stress is ergometry. Gated SPECT and attenuation correction do not yet represent standards of MPS practice in Germany, which indicates some potential of optimization.
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Zimny M, Schreckenberger M, Reinartz P, Nowak B, Ostwald E, Schäfer W, Block S, Setam K, Büll U, Sabri O. Characterization of radioiodine therapy failures in Graves’ disease. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1623985] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim of this study was a characterization of radioiodine therapy (RIT) failures in Graves’ disease without simultaneous Carbimazole. Method: 226 patients with a confirmed diagnosis of Graves’ disease received 686.8 ± 376.4 MBq of iodine-131 orally for thyroid ablation. Target dose was 250 Gy. All patients were followed up for 6 months. Therapy failures were compared with successes regarding possible influencing variables initial thyroid volume, thyroid function, immune activity (TRAb), 1-131 uptake, effective half-life, absorbed energy dose, age and gender. Results: 212 of 226 patients (93.8%) were treated successfully, 14 (6.2%) showed a hyperthyroidism relapse within 6 months which required a second radioiodine therapy. A success rate of 92.5% (62/67) could also be achieved with 67 patients who were hyperthyroid at the time of RIT. Compared to the therapy successes, the 14 failures achieved significantly lower absorbed doses (223.8 ±76.6 Gyvs. 285.2 ±82.1 Gy, ρ <0.005), but with no significant differences regarding age, thyroid volume, function or TRAb (all ρ >0.2). Of the 14 failures, η = 8 reached an absorbed dose <200 Gy and η = 1 a dose <250 Gy, although 5 of the failures reached an absorbed dose of >250 Gy. Stepwise logistic regression revealed only absorbed energy dose as a variable significantly influencing therapy success (p <0.005), but no influence of initial thyroid volume, function, TRAb value, age (all ρ >0.2) or gender (p = 0.13). Two-tailed Fisher’s exact test showed no significant influence of gender on success rates (failures/successes: male 1 /36, female 13/176, ρ = 0.48). Conclusions: Except for the absorbed energy dose, no other significant variable influencing the outcome of radioiodine therapy in Graves’ disease without simultaneous Carbimazole could be found. It should be noted, though, that 5 therapy failures (2.2%) reached an absorbed energy dose of >250 Gy.
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Burchert W, Bengel FM, Zimmermann R, vom Dahl J, Schäfer W, Schober O, Kluge R, Schäfers M, Lindner O. Myocardial perfusion scintigraphy 2006 in Germany. Nuklearmedizin 2018. [DOI: 10.3413/nukmed-0158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
SummaryAim: This second survey was to deliver further information on myocardial perfusion scintigraphy (MPS) in Germany in 2006. Method: 351 questionnaires were evaluated: 207 private practices (PP), 117 hospitals (HO), 27 from university hospitals (UH). Results: MPS of 106 331 patients were reported, 85% were investigated with 99mTc-perfusion tracers. 74% [2005=72%] were performed in PP, 17% [2005=15%] in HO and 9% [2005=13%] in UH. PP, which participated in 2005 and 2006, demonstrated an increase by 3,9% (HO 0%, UH –13,0%). The type of stress was pharmacological in 27% [2005=22%]; 54% adenosine (of these 29% with exercise), 37% dipyridamole (of these 56% with exercise), and 9% dobutamine. Gated SPECT was performed in 42% [2005=36%] of all restand in 39% [2005=32%] of all stress MPS. An attenuation correction was used by 69 [2005=78] institutions. 40% of all MPS were performed in patients suspected to have CAD. 24% of all institutions reported changes in the use of MPS by competing methods. Conclusion: There is a small increase of MPS between 2005 and 2006 despite competing methods. Gated SPECT has experienced more acceptance. Suspicion of CAD is an important indication of MPS. In order to tap the full potential of MPS a gated SPECT should be performed routinely.
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Gröner A, Broumis C, Fang R, Nowak T, Popp B, Schäfer W, Roth NJ. Effective inactivation of a wide range of viruses by pasteurization. Transfusion 2017; 58:41-51. [PMID: 29148053 PMCID: PMC7169671 DOI: 10.1111/trf.14390] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 09/11/2017] [Accepted: 09/17/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Careful selection and testing of plasma reduces the risk of blood‐borne viruses in the starting material for plasma‐derived products. Furthermore, effective measures such as pasteurization at 60°C for 10 hours have been implemented in the manufacturing process of therapeutic plasma proteins such as human albumin, coagulation factors, immunoglobulins, and enzyme inhibitors to inactivate blood‐borne viruses of concern. A comprehensive compilation of the virus reduction capacity of pasteurization is presented including the effect of stabilizers used to protect the therapeutic protein from modifications during heat treatment. STUDY DESIGN AND METHODS The virus inactivation kinetics of pasteurization for a broad range of viruses were evaluated in the relevant intermediates from more than 15 different plasma manufacturing processes. Studies were carried out under the routine manufacturing target variables, such as temperature and product‐specific stabilizer composition. Additional studies were also performed under robustness conditions, that is, outside production specifications. RESULTS The data demonstrate that pasteurization inactivates a wide range of enveloped and nonenveloped viruses of diverse physicochemical characteristics. After a maximum of 6 hours' incubation, no residual infectivity could be detected for the majority of enveloped viruses. Effective inactivation of a range of nonenveloped viruses, with the exception of nonhuman parvoviruses, was documented. CONCLUSION Pasteurization is a very robust and reliable virus inactivation method with a broad effectiveness against known blood‐borne pathogens and emerging or potentially emerging viruses. Pasteurization has proven itself to be a highly effective step, in combination with other complementary safety measures, toward assuring the virus safety of final product.
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Affiliation(s)
| | - Connie Broumis
- Global Pathogen Safety, CSL Behring (Australia) Pty Ltd, Broadmeadows, Victoria, Australia
| | - Randel Fang
- Global Pathogen Safety, CSL Behring (Australia) Pty Ltd, Broadmeadows, Victoria, Australia
| | - Thomas Nowak
- Global Pathogen Safety, CSL Behring GmbH, Marburg, Germany
| | - Birgit Popp
- Global Pathogen Safety, CSL Behring GmbH, Marburg, Germany
| | | | - Nathan J Roth
- Global Pathogen Safety, CSL Behring AG, Bern, Switzerland
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Roth NJ, Schäfer W, Alexander R, Elliott K, Elliott-Browne W, Knowles J, Wenzel JJ, Simon TL. Low hepatitis E virus RNA prevalence in a large-scale survey of United States source plasma donors. Transfusion 2017; 57:2958-2964. [PMID: 28833188 DOI: 10.1111/trf.14285] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/12/2017] [Accepted: 07/05/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) is a small, nonenveloped, single-stranded, RNA virus of emerging concern in industrialized countries. HEV transmission through transfusion of blood components has been reported, but not via plasma-derived medicinal products (PDMPs) manufactured with virus inactivation and/or removal steps. This study aimed to determine the prevalence of HEV among US source plasma donors. STUDY DESIGN AND METHODS Samples were collected from US source plasma donors at centers across the United States and were initially screened for HEV RNA in 96-sample minipools using the Roche cobas HEV test on the cobas 8800 system. Assuming a sensitivity of 18.6 IU/mL, the minipool screening strategy allowed for reliable detection of individual donations with HEV RNA titers of more than 2 × 103 IU/mL. Reactive minipools were resolved to individual donations, which were further analyzed to quantify viral RNA concentration, determine HEV genotype, and immunoglobulin (Ig)G and IgM HEV antibody status. RESULTS A total of 128,020 samples were collected from 96 CSL Plasma centers in the United States, representing 27 states. The prevalence of HEV RNA-positive samples was 0.002% with three unique HEV-positive donors identified, all HEV Subgenotype 3a. Virus titers of HEV-positive samples were relatively low (103 -104 IU HEV RNA/mL). One positive donation was HEV IgG seropositive. CONCLUSION Routine screening of US source plasma donations for HEV would not substantially improve the safety of most PDMPs. The low prevalence and potential viral load of HEV, together with effective virus reduction steps in manufacturing processes, results in a low residual risk and acceptable safety margins for PDMPs derived from US plasma donors.
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Affiliation(s)
| | | | | | | | | | | | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, University Medical Center Regensburg, Regensburg, Germany
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Kee S, Weber D, Popp B, Nowak T, Schäfer W, Gröner A, Roth NJ. Pathogen safety and characterisation of a highly purified human alpha 1-proteinase inhibitor preparation. Biologicals 2017; 47:25-32. [PMID: 28377078 DOI: 10.1016/j.biologicals.2017.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 01/17/2017] [Accepted: 03/08/2017] [Indexed: 10/19/2022] Open
Abstract
Alpha1-proteinase inhibitor (A1PI) deficiency is a genetic condition predisposing to emphysema. Respreeza/Zemaira, a therapeutic preparation of A1PI, is prepared from human plasma. This article describes the purity and stability of Respreeza/Zemaira and the capacity of virus and prion reduction steps incorporated into its manufacturing process. Purity and stability of Respreeza/Zemaira were analysed using established methods. To test pathogen clearance capacity, high levels of test viruses/prions were spiked into aliquots of production intermediates and clearance studies were performed for selected manufacturing steps, under production and robustness conditions, using validated scale-down models. Respreeza/Zemaira had a purity of 99% A1PI and consisted of 96% monomers. It remained stable after storage for 3 years at 25 °C. Specific activity was 0.895 mg active A1PI/mg protein. Pasteurisation inactivated enveloped viruses and the non-enveloped hepatitis A virus. 20 N/20 N virus filtration was highly effective and robust at removing all tested viruses, including parvoviruses, to below the limit of detection. Cold ethanol fractionation provided substantial reduction of prions. The manufacturing process of Respreeza/Zemaira ensures the production of a stable and pure product. Taking into consideration the donor selection process, the testing of donations, and the highly effective virus and prion reduction, Respreeza/Zemaira has a high safety margin.
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Affiliation(s)
- Scott Kee
- CSL Behring LLC, Box 511, Kankakee, IL, USA.
| | | | - Birgit Popp
- CSL Behring GmbH, Emil-von-Behring-Strasse 76, 35041 Marburg, Germany
| | - Thomas Nowak
- CSL Behring GmbH, Emil-von-Behring-Strasse 76, 35041 Marburg, Germany
| | - Wolfram Schäfer
- CSL Behring GmbH, Emil-von-Behring-Strasse 76, 35041 Marburg, Germany
| | - Albrecht Gröner
- CSL Behring GmbH, Emil-von-Behring-Strasse 76, 35041 Marburg, Germany
| | - Nathan J Roth
- CSL Behring LLC, 1020 First Avenue PO Box 61501, King of Prussia, PA 19406-0901, USA
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Roth NJ, Schäfer W, Popp B, Stucki M, Fang R. Verification of effective Zika virus reduction by production steps used in the manufacture of plasma-derived medicinal products. Transfusion 2017; 57:720-721. [DOI: 10.1111/trf.14038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Nathan J. Roth
- Global Pathogen Safety, CSL Behring; King of Prussia PA
- CSL Behring AG; Bern Switzerland
| | - Wolfram Schäfer
- Global Pathogen Safety, CSL Behring; King of Prussia PA
- CSL Behring GmbH; Marburg Germany
| | - Birgit Popp
- Global Pathogen Safety, CSL Behring; King of Prussia PA
- CSL Behring GmbH; Marburg Germany
| | - Martin Stucki
- Global Pathogen Safety, CSL Behring; King of Prussia PA
- CSL Behring AG; Bern Switzerland
| | - Randel Fang
- Global Pathogen Safety, CSL Behring; King of Prussia PA
- CSL Behring (Australia) Pty Ltd; Broadmeadows Australia
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Nowak T, Popp B, Gröner A, Schäfer W, Kalina U, Enssle K, Roth NJ. Pathogen safety of a pasteurized four-factor human prothrombin complex concentrate preparation using serial 20N virus filtration. Transfusion 2017; 57:1184-1191. [PMID: 28191640 DOI: 10.1111/trf.14010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 12/06/2016] [Accepted: 12/08/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Beriplex P/N/Kcentra/Coaplex/Confidex is a four-factor human prothrombin complex concentrate (PCC). Here, we describe the pathogen safety profile and biochemical characteristics of an improved manufacturing process that further enhances the virus safety of Beriplex P/N. STUDY DESIGN AND METHODS Samples of product intermediates were spiked with test viruses, and prions were evaluated under routine production and robustness conditions of the scale-down version of the commercial manufacturing process for their capacity to inactivate or remove pathogens. The PCC was characterized by determining the activity of Factor (F)II, FVII, FIX, FX, protein C, and protein S and the concentration of heparin and antithrombin III in nine product lots. RESULTS The manufacturing process had a very high virus reduction capacity for a broad variety of virus challenges (overall reduction factors ≥15.5 to ≥18.4 log for enveloped viruses and 11.5 to ≥11.9 log for nonenveloped viruses). The high virus clearance capacity was provided by two dedicated virus reduction steps (pasteurization and serial 20N virus filtration) that provided effective inactivation and removal of viruses and a purification step (ammonium sulfate precipitation and adsorption to calcium phosphate) that contributed to the overall virus removal capacity. The diethylaminoethyl (DEAE) chromatography and ammonium sulfate precipitation steps removed prions to below the limit of detection. The levels of different clotting factors in the final product were well balanced. CONCLUSION The improved manufacturing process of Beriplex P/N further enhances the margin of pathogen safety based on its capacity to remove and inactivate a wide range of virus challenges.
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Schäfer W, Kretschmer E. Zum anodischen Verhalten von Kupfer in Pentan-2,4-dion in Gegenwart von Chloridionen. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1987-26844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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vom Dahl J, Schäfer W. Myokardszintigrafie: aktueller Stand. Aktuel Kardiol 2016. [DOI: 10.1055/s-0042-116226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J. vom Dahl
- Klinik für Kardiologie, Kliniken Maria Hilf GmbH Mönchengladbach
| | - W. Schäfer
- Klinik für Nuklearmedizin, Kliniken Maria Hilf GmbH Mönchengladbach
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Schäfer W. Primärdiagnostik der KHK: Nuklearmedizinische Sicht. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schäfer W, Demsey A, Frank H, Hunsmann G, Lange J, Moennig V, Pister L, Bolognesi DP, Green RW, Luftig RB, Shaper J, Hüper G. Morphological, chemical, and antigenic organization of mammalian C-type viruses. Bibl Haematol 2015:497-515. [PMID: 51634 DOI: 10.1159/000397568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
New features in the architecture of mammalian type C viruses, in particular knoblike surface projections and hexagonally arranged subunits on the core shell could be demonstrated by electron microscopy, taking advantage of newly developed preparation techniques. As examples, murine leukemia viruses (MuLVs) and newly isolated porcine and bovine C viruses are presented. The major proteins of a MuLV were isolated and partially characterized in chemical terms and with respect to their serological and other biological activities, such as interfering and hemagglutinating (HA) capacity. Most of the characterized proteins could be localized in particular substructures of the virion either by selective removal or isolation of electron microscopically identifiable constituents. The information obtained allowed the design of a more detailed model of mammalian C viruses. Special attention was devoted to the further characterization of interspecies antigens of mammalian C viruses. Different antigenic determinants were revealed. Their distribution allows further subgrouping of mammalian C viruses.
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Groenewegen P, Heinemann S, Gress S, Schäfer W. Primary care workforce development in Europe. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku164.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kunze M, Morfeld C, Klar M, Markfeld-Erol F, Rasenack R, Prömpeler H, Schäfer W. Interleukin-6 und Tumor necrosis factor-alpha als Prädiktoren eines Fetalen Inflammatory Response Syndrome beim frühen vorzeitigen Blasensprung. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Affiliation(s)
- I. Halevy
- Physics Dept, Nuclear Research Center - Negev, P. O. Box 9001 Beer Sheva, Israel
| | - S. Salhov
- Physics Dept, Nuclear Research Center - Negev, P. O. Box 9001 Beer Sheva, Israel
| | - G. Kimmel
- Physics Dept, Nuclear Research Center - Negev, P. O. Box 9001 Beer Sheva, Israel
| | - A. P. Gonçalves
- Institute Tecnológico e Nuclear, Departamento de Quimica, P-2686 Sacavém, Portugal
| | - W. Schäfer
- Mineralogisch-PetrologischesInstitut, Universitat Bonn, DE-53115 Bonn, Germany
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Lohaus E, Bios I, Schäfer W, Rüdiger W. Natürliche Hemmstoffe von Keimung und Wachstum II Isolierung und Struktur von Hemmstoffen aus , Avena sativa L.+ / Natural Inhibitors of Germination and Growth II Isolation and Structure of Inhibitors from Avena sativa L. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znc-1982-0912] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Extracts from oat husks which inhibit germination of a variety of seeds were fractionated. After mild alkaline hydrolysis, two active fractions A1 and A2 were obtained. From A1 which contains mainly aliphatic di- and tricarboxylic acids, the inhibitor was isolated by chromatographic procedures and identified as 1,3,4-pentanetricarboxylic acid (11 b) by mass spectrometry. The structure was confirmed by total synthesis of the compound in the form of a mixture of diastereomers 11 a/11 b. From A2, two aromatic compounds were isolated by chromatography and identified by gas chromatography and mass spectrometry as 3,4-dimethoxyacetophenone (12) and dimethoxybutylbenzene. Compounds with similar structures were compared with the natural germination inhibitors with regard to their bioactivity.
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Affiliation(s)
- Edith Lohaus
- Botanisches Institut der Universität München, Menzinger Straße 67, 8000 München 19
| | - Inge Bios
- Botanisches Institut der Universität München, Menzinger Straße 67, 8000 München 19
| | | | - Wolfhart Rüdiger
- Botanisches Institut der Universität München, Menzinger Straße 67, 8000 München 19
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Rott R, Frank H, Schäfer W. Notizen: Isolierung und Eigenschaften der hämagglutinierenden Komponente des Virus der Newcastle Disease. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znb-1961-0917] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- R. Rott
- Max-Planck-Institute für Virusforschung und Biologie (Abt. WEIDEL), Tübingen
| | - H. Frank
- Max-Planck-Institute für Virusforschung und Biologie (Abt. WEIDEL), Tübingen
| | - W. Schäfer
- Max-Planck-Institute für Virusforschung und Biologie (Abt. WEIDEL), Tübingen
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Schäfer W, Braunitzer G, Stangl A. Direkte allosterische Wechselwirkung von Sauerstoff und Bicarbonat: N-Acetyl-Ala-Ser-Phe, die N-terminale Sequenz der β-Ketten der Hämoglobine des Nilkrokodils (Crocodylus niloticus) und des Mississippi krokodils (Alligator mississippiensis) / Direct Allosteric Interaction of Oxygen and Bicarbonate: N-Acetyl-alanyl-seryl-phenylalanine, N-Terminal Sequence of the β-Chains of the Haemoglobins of Nil Crocodile (Crocodylus niloticus) and Mississippi Crocodile (Alligator mississippiensis). ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znc-1981-9-1037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
To elucidate the molecular mechanism of the direct allosteric exchange of oxygen and hydrogen carbonate in the hemoglobins of crocodiles, the N-terminal sequence of the β-chains of the crocodiles of the Nile (Crocodylus niloticus) and of the Mississippi (Alligator mississippiensis) was studied. The N-terminal end of the peptide is blocked. By mass spectrometry the N-terminal sequences of both species were found to be N-acetyl-alanyl-seryl-phenyl-alanine. These data explain the absence of hemoglobin-phojphate interaction, the data are in good agreement with the stereochemistry postulated for allosteric exchange of oxygen and hydrogen carbonate in crocodilian hemo globins.
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Affiliation(s)
- W. Schäfer
- Max-Planck-Institut für Biochemie, Am Klopferspitz, D-8033 Martinsried bei München
| | - G. Braunitzer
- Max-Planck-Institut für Biochemie, Am Klopferspitz, D-8033 Martinsried bei München
| | - A. Stangl
- Max-Planck-Institut für Biochemie, Am Klopferspitz, D-8033 Martinsried bei München
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Schwarz H, Thiel HJ, Schäfer W. Notizen: Spontane Leukämie der AKR-Mäuse. Erfolgreiche passive Immunisierung mit Ziegen- Antikörper gegen isoliertes Glykoprotein gp71 des Friend-Leukämie-Virus /Spontaneous Leukemia of AKR Mice. Successful Passive Im m unization with Goat Anti bodies against Isolated Glycoprotein gp71 of Friend Leukemia Virus. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znc-1977-5-628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The occurrence of fatal spontaneous leukemia in AKR mice could be drastically reduced by passive immunization with goat antibody against isolated murine Friend virus glycoprotein gp71, possessing high group specific reactivity. The success depended on the time of antibody application. The best results were achieved when mothers and babies were inoculated.
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Affiliation(s)
- H. Schwarz
- Max-Planck-Institut für Virusforschung, Tübingen
| | - H.-J. Thiel
- Max-Planck-Institut für Virusforschung, Tübingen
| | - W. Schäfer
- Max-Planck-Institut für Virusforschung, Tübingen
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Seidl M, Zolnhofer G, Gunser S, Ennker J, Schäfer W, Tietze L. [Psammomatous melanotic schwannoma as indicator of a Carney complex]. Pathologe 2014; 34:343-6. [PMID: 23306533 DOI: 10.1007/s00292-012-1736-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Within a few months a 31-year-old female patient was diagnosed with a psammomatous melanotic schwannoma, an atrial myxoma and microfollicular adenomas in both thyroid lobes. Therefore, sufficient diagnostic criteria of a Carney complex were fulfilled. The Carney complex is an inherited autosomal dominant disorder with highly variable phenotypes, which was initially described by Carney in 1985 as a complex of myxomas, spotty skin pigmentation and endocrine overactivity. Pathologists should consider this differential diagnosis in reports when confronted with a psammomatous melanotic schwannoma.
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Affiliation(s)
- M Seidl
- Institut für Pathologie, Universitätsklinikum Freiburg, Freiburg, Germany
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Nowak T, Schäfer W, Gröner A. EFFECTIVE PATHOGEN REDUCTION FOR A PLASMA-DERIVED PROTHROMBIN COMPLEX CONCENTRATE THROUGH MULTIPLE DEDICATED MEASURES. J Thromb Haemost 2014. [DOI: 10.1111/j.1538-7836.2007.tb01022.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lindner O, Bengel FM, Hacker M, Schäfer W, Burchert W. Use of myocardial perfusion imaging and estimation of associated radiation doses in Germany from 2005 to 2012. Eur J Nucl Med Mol Imaging 2014; 41:963-71. [PMID: 24519554 PMCID: PMC3978223 DOI: 10.1007/s00259-013-2683-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 12/20/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE For several years the Working Group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine has been performing a regular survey to obtain information on technique, utilization and development of myocardial perfusion scintigraphy (MPS). Currently, data of six surveys from 2005 to 2012 are available. The aim of this paper is to deliver a general and comprehensive overview of all surveys documenting the course of patient doses over time and the development of the method. METHODS A one-page questionnaire with number of MPS patients, number of stress and rest MPS, referral structure and several technical issues was sent to all centres performing MPS in Germany and evaluated. With the data on protocol utilization, effective MPS patient doses were estimated. RESULTS MPS per million population (pmp) varied between 2,380 and 2,770. In 2012, MPS pmp showed a slight increase for the first time. From 2005 to 2009 the angiography to MPS ratio increased from 3.4 to 4.4, and the revascularization to MPS ratio decreased from 0.66 to 0.53. In 2012, both indices demonstrated an opposite trend for the first time (4.1 and 0.55). A total of 108 centres participated in all surveys. They showed an increase in MPS patients of 4.0 % over the reporting period. In 2012, more than 50 % of the centres experienced no change or an increase in MPS numbers. The leading single competitor was MRI, followed by angiography and stress echocardiography. (201)Tl studies have decreased since 2005 from 20 to 5 %. (99m)Tc MPS studies showed a mild increase in 2-day protocols. In 2012, the average effective dose per patient was estimated at 7.4 mSv. Due to the decreasing use of (201)Tl, a mild decline over the observation period can be documented. Dynamic exercise stress was the most common stress test and adenosine the leading pharmacological stress agent, with a growing percentage. In 2012, the regadenoson percentage was 9 %. Gated single photon emission computed tomography (SPECT) noted an increasing acceptance with >70 % in 2012. The segmental scoring of perfusion studies had a low acceptance. Ambulatory care cardiologists represented the major referral group. CONCLUSION Germany has a moderate to moderate-high MPS utilization rate. Nevertheless, coronary artery disease (CAD) diagnosis and disease management are dominated by angiography. The survey data reveal a positive trend in MPS and a decrease in average patient dose reflecting good practice with guideline adherence, the implementation of technical improvements and success in training.
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Affiliation(s)
- O Lindner
- Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia, University Hospital of the Ruhr University Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany,
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Kunze M, Morfeld CA, Klar M, Markfeld-Erol F, Rasenack R, Prömpeler H, Schäfer W. Prädiktion eines Fetal Inflammatory Response Syndrome beim frühen vorzeitigen Blasensprung durch Interleukin-6 und TNF-alpha bei nicht-invasiver Probengewinnung. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hoffmann K, Schober J, Schäfer W, Maier M. Tackling the reasons for GP shortage: The workload of GPs in rural and urban areas in Austria. A cross-sectional study within the framework of QUALICOPC. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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de Jong J, Schäfer W. The problem: high burden on the health system? Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
BACKGROUND Human plasma-derived products--such as C1 esterase inhibitor (C1-INH) concentrate, used to treat hereditary angioedema--carry with them the risk of transmitting blood-borne viruses and, theoretically, prion proteins. To minimize this risk, three complementary approaches are implemented: selection and testing of plasma donations for the absence of pathogenic blood-borne viruses, similarly testing and releasing the plasma pool for fractionation, and ensuring that the manufacturing process includes validated steps for pathogen inactivation and removal. STUDY DESIGN AND METHODS This article describes the selection of plasma for the production of C1-INH and the studies used to confirm the pathogen reduction capacity of the manufacturing process: three independent virus reduction steps--pasteurization, hydrophobic interaction chromatography (HIC), and virus filtration--and two prion reduction steps. Samples of product intermediates from the manufacturing steps were spiked with a panel of enveloped and nonenveloped viruses and two prion preparations and subjected to a valid scaled-down version of the respective manufacturing steps resulting in the quantification of the pathogen reduction factors. RESULTS Validation studies demonstrated overall virus reduction factors for all viruses of more than 15 log, considerably exceeding the potential amount of virus present in a plasma pool for fractionation. Prion proteins were also efficiently removed by the manufacturing process, as currently determined in evaluating the prion removal capacity of the ammonium sulfate precipitation and HIC steps. CONCLUSION The pathogen reduction capacity demonstrated here indicates that the manufacturing process of the C1-INH Berinert is highly effective for reducing enveloped and nonenveloped viruses and prion proteins.
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Affiliation(s)
- Albrecht Gröner
- Department of Pathogen Safety, CSL Behring, Marburg, Germany
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Lindner O, Burchert W, Bengel FM, Zimmermann R, Vom Dahl J, Schäfer W, Schober O, Schäfers M. [Myocardial perfusion scintigraphy 2008 in Germany - results of the fourth query]. Nuklearmedizin 2010; 49:65-72. [PMID: 20198276 DOI: 10.3413/nukmed-0282] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Accepted: 12/08/2009] [Indexed: 11/20/2022]
Abstract
AIM The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine in cooperation with the working group Nuclear Cardiology of the German Cardiac Society herewith present the results of the 4th survey on myocardial perfusion scintigraphy (MPS) of the year 2008. METHOD 310 questionnaires (191 private practices (PP), 93 hospitals (HO), 31 university hospitals (UH)) were evaluated. RESULTS MPS of 98947 patients were reported. 15% of them were younger than 50 y, 57% between 50 and 70 y and 28% older than 70 y. 88% [2007: 83%] of all were studied with Tc-99m perfusion tracers. The patient radiation exposure of a stress and rest protocol considering German standard recommended doses was 8.5 mSv, of a stress-only protocol 1.9 mSv. 77% [2007: 76%] of the MPS were performed in PP, 15% [2007: 15%] in HO and 8% [2007: 9%] in UH. From 2005 to 2008 there was a mild increase in the MPS numbers by 1.2% (PP +7.1%, HO -5.5%, UH -31.4%). The type of stress was pharmacological in 30% [2007: 27%]; 68% adenosine (of these 22% with exercise), 29% dipyridamole (of these 64% with exercise), and <1% dobutamine. Gated SPECT was performed in 46% [2007: 47%] of all rest and in 42% [2007: 44%] of all stress MPS. 62% [2007: 61%] of all institutions did not use perfusion scores. CONCLUSION The MPS numbers from 2005 to 2008 in Germany can be regarded as stable. However, there are considerable shifts from HO and UH to PP. The well known potential of MPS considering risk stratification and functional analysis has not been tapped so far. Both gated SPECT and a quantitative perfusion analysis should be performed routinely in every patient.
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Affiliation(s)
- O Lindner
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Georgstr. 11, 32545 Bad Oeynhausen, Germany.
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Cisek A, Schäfer W, Szczurek A. Production ofZ0bosons with rapidity gaps: Exclusive photoproduction inγpandppcollisions and inclusive double diffractiveZ0’s. Int J Clin Exp Med 2009. [DOI: 10.1103/physrevd.80.074013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Lindner O, Burchert W, Bengel FM, Zimmermann R, vom Dahl J, Schäfer W, Schober O, Schäfers M. [Myocardial perfusion scintigraphy 2007 in Germany--results of the query and current status]. Nuklearmedizin 2009; 48:131-7. [PMID: 19384452 DOI: 10.3413/nukmed-0226] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Accepted: 03/30/2009] [Indexed: 11/20/2022]
Abstract
AIM This third survey of the working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine in cooperation with the working group Nuclear Cardiology of the German Cardiac Society was to deliver information on the procedures and in particular on the development of myocardial perfusion scintigraphy (MPS) from 2005 to 2007. METHOD 370 questionnaires (222 private practices (PP), 117 hospitals (HO), 31 university hospitals (UH)) were evaluated. RESULTS MPS of 114,374 patients were reported, 83% were investigated with 99mTc-perfusion tracers. 76% [2006=74%] were performed in PP, 15% [2006=17%] in HO and 9% [2006=9%] in UH. Diabetics represented 21% of all MPS patients in 2007. Data of 215 institutions which participated all from 2005 to 2007 showed an increase in MPS of 2.3% (PP +6.8%, HO -4.5%, UH -18.2%). The type of stress was pharmacological in 27% [2006 = 27%]; 67% adenosine (of these 25% with exercise), 31% dipyridamole (of these 55% with exercise), and 2% dobutamine. Gated SPECT was performed in 47% [2006 = 42%] of all rest and in 44% [2006 = 39%] of all stress MPS. 61% [2006 = 83%] of all institutions did not apply perfusion scores. 20% [2006 = 24%] of the institutions reported changes in the use of MPS by competing methods. CONCLUSION There is a small increase of MPS between 2005 and 2007 despite competing methods. Gated SPECT has experienced more acceptance, but is still underrepresented. As compared to the European average and general standards of MPS a considerable backlog accounts to pharmacological stress tests, gated SPECT and perfusion scores.
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Affiliation(s)
- O Lindner
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen.
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